PEACE Signs Application

*required information

School Information

School Name*	Required School District* Required Grades*
Address*	Required
City*	Required State* Required Zip Code* RequiredInvalid format.
Principal*	Required Phone* RequiredInvalid format. Fax E-mail
Booking Contact*	Required Phone* RequiredInvalid format. Fax E-mail*RequiredInvalid format.
Facilities Manager	Phone
Health Coordinator/ Nurse/Counselor	Phone

School Detail Information

Enrollment Information
Total school enrollment*:	RequiredInvalid format.
Total 3rd-6th grade enrollment:	Invalid format.
Assembly Information
# of Grade 3 classes attending:
# of Grade 4 classes attending:
# of Grade 5 classes attending:
# of Grade 6 classes attending:
Year-round school:	Yes No
Tracks:	Single Multi
School type:	Public Private
School starts:		School ends:
Breakfast starts:		Breakfast ends:
Lunch starts:		Lunch ends:
After School Program starts:		After School Program ends:

Performance Space

Type of Room*:	Auditorum Gym Cafeteria Multi-purpose Room Other Minimum number of selections not met.	Type of Seating*:	Chairs Fixed Seating Floor Bleachers Other Minimum number of selections not met.
Room Size*:	length Required width Required height Required
Floor to Ceiling Height:
Room Seating Capacity:
Ground floor access (no stairs)?	Yes No
Outside door for unloading?	Yes No
Loading ramp to performance space?	Yes No
Stairs between loading door and performance space?	Yes No # of stairs
Obstacles to unloading?	Yes No If yes please explain:

Directions
Freeway Driving Time: Minutes from Freeway: Estimated Total Driving Time:

Please provide directions to your school. Our cast will be traveling from downtown Oakland.
(Please be specific and use Right and Left when describing turns, rather than North, South, etc.)

Background information
Why does your school need or want PEACE Signs?*
Required

How will your school ensure the implementation of PEACE Signs and the lasting impact of the program?
Who will be responsible for this?*

RequiredA value is required.

Describe any violence prevention, health and wellness, after-school or community development activities that are underway at your school or that your school is part of. Would PEACE Signs support these activities, and if so, in what way?*

Required